Linking the Price of Cancer Drug Treatments to Their Clinical Value
| Autor: | Filippo Drago, Laura Longo, Valentina Drago, Salvatore Salomone, Americo Cicchetti, Andrea Navarria, Lucia Gozzo, Giacomo Pignataro, S. Mansueto |
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| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
Bevacizumab Total cost Afatinib Cost-Benefit Analysis Ipilimumab Antineoplastic Agents Pharmacology Drug Costs 03 medical and health sciences 0302 clinical medicine Quality of life Neoplasms Prevalence Medicine Humans Pharmacology (medical) 030212 general & internal medicine health care economics and organizations Survival analysis Cost–benefit analysis business.industry Dabrafenib General Medicine Survival Analysis Treatment Outcome Italy 030220 oncology & carcinogenesis Emergency medicine Quality of Life Quinazolines business Algorithms medicine.drug |
| Zdroj: | Clinical drug investigation. 36(7) |
| ISSN: | 1179-1918 |
| Popis: | Appropriate pricing of medications is one of the ultimate goals for decision makers, but reliable data on the risk/benefit ratio are often lacking when a Marketing Authorization Application is submitted. Here we propose a method to consistently evaluate price adequacy, which we applied to six anticancer medications approved in Italy in recent years. We obtained ratios of cost per survival per day (cost/survival/day) by dividing the total costs of evaluated medications for the median survival gain in days. Each cost/survival/day corresponds to a crude score, with 0 assigned to a cost/survival/day ≥€586. The maximum price considered as adequate was €91 cost/survival/day (score 75) while a score of 100 corresponded to a cost/survival/day ≤€11, based on the thresholds set by the British National Health System (NHS) and the “willingness-to-pay” of the Italian NHS. Crude scores were then adjusted using correction factors for efficacy, safety, quality of life, and prevalence of disease. None of the analyzed medications (abiraterone, afatinib, aflibercept, bevacizumab, dabrafenib, and ipilimumab) achieved a final score of 75, corresponding to adequate pricing. The final score for afatinib was the highest with 55 points. Prices of all the other drugs resulted in being inadequate, with negative final scores for bevacizumab, dabrafenib, and ipilimumab. This method may be considered a tool for the evaluation of appropriateness of price proposed at negotiation and could represent a reliable resource for decision-making. Furthermore, this analysis suggests that most recently approved cancer drugs in Italy do not fulfill price adequacy. |
| Databáze: | OpenAIRE |
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